Lived Experience of Intimate Partner Violence among Women with HIV/AIDS in Sero-discordant Couples in Rwanda: A Qualitative Phenomenological Study

Abstract Background Intimate partner violence (IPV) is a global public health and human rights problem that disproportionately affects women. Women living with HIV who are in sero-discordant relationships, where one partner is HIV-positive and the other is HIV-negative, face a heightened risk of IPV, particularly around the disclosure of their HIV status. In Rwanda, documented evidence on the lived experience of IPV among this specific population remains scarce. This study explored the lived experience of IPV among HIV-positive women in sero-discordant couples in Rwanda. Methods A qualitative study using a descriptive phenomenological design was conducted among 15 purposively sampled HIV-positive women in sero-discordant relationships receiving care and support services at the Rwanda Network of People Living with HIV (RRP+), Kigali, between March and April 2023. Data were collected through face-to-face in-depth interviews guided by a semi-structured interview guide and analyzed thematically using ATLAS.ti software, following the six-step framework of Kiger and Varpio. Results Five interrelated themes emerged: (1) changes in the relationship with the partner, (2) awareness of HIV in sero-discordant couples, (3) collaboration and exchange, (4) impact and determination, and (5) resolving and recommendations. Participants described psychological, socio-economic, sexual, and physical abuse linked to HIV status disclosure, with negative effects on mental health, economic stability, and sexual wellbeing. Peer educators, close friends, relatives, and health facility nurses were the main sources of support, although several women coped in silence. Participants recommended stronger legal deterrence for perpetrators, community advocacy, more frequent home visits by peer educators, and economic empowerment programs for women. Conclusions IPV is a significant and often under-addressed problem among HIV-positive women in sero-discordant relationships in Rwanda, closely tied to the process of HIV status disclosure. Strengthening legal protection, facilitating provider-supported disclosure, and expanding peer support and economic empowerment programs are needed to reduce IPV in this population.